The annual meeting of the World Health Organization (WHO) ends this Saturday in Geneva after four days of reviewing the main health problems of the planet. Delegates from all member countries discussed and voted on resolutions for political action on tuberculosis, cholera, polio, vaccines, and snakebites, among many other issues. These are the main ones.
The Ebola outbreak that has erupted in the Democratic Republic of Congo is facing a turning point. In the coming weeks, it could spread to urban areas or be kept under control. Vaccination of at-risk populations has begun. The response has been rapid and WHO Director-General Tedros Adhanom Ghebreyesus has thanked all health workers for their efforts. The organization’s advisory committee issued a report on protocols for combating outbreaks of this type. According to the document, the program has proven to be effective in leading health responses to humanitarian crises, although “further progress is needed”.
Health conditions in the occupied Palestinian territory
Assembly delegates reaffirmed the need for full coverage of health services in the Occupied Palestinian Territory, recognizing that acute shortages of financial and medical resources are jeopardizing people’s access to health and preventive programs. They agreed to request the Director-General to support Palestinian health services.
Access to medicines and vaccines
Access to essential drugs seemed until recently to be a challenge faced mainly by low-income countries. But the rising costs of new compounds have put pressure on all health systems to provide affordable access. Besides, problems such as antimicrobial resistance and opiate abuse highlight the need to improve drug use. Delegates have asked WHO to develop a five-year roadmap to address these problems. It is also one of the keys to achieving universal health coverage, and one of the targets of the Sustainable Development Goals.
The Member States called for intensified action in the global fight against non-communicable diseases (NCDs). They reiterated that the international community is committed to reducing premature deaths from these diseases by one third by 2030, mainly cardiovascular, cancers, diabetes, and chronic respiratory diseases, as well as promoting mental health and well-being. Every year, 15 million people aged 30-70 die from NCDs. The Assembly recognized that improved political leadership is needed to accelerate prevention and to take action to reduce the major risks of these ills: tobacco use, physical inactivity, harmful alcohol use, and unhealthy diets, as well as air pollution. “Health systems must be strengthened by implementing effective measures to better detect people at risk and provide therapies and pharmacological services to reduce deaths from heart attacks, strokes, and diabetes. Prevention and treatment of mental disorders also require urgent action,” delegates agreed.
Polio is a disease that is close to eradication. Cases have declined by more than 99 percent since 1988, when there were an estimated 350,000 cases in more than 125 endemic countries, compared to 37 reported in 2016. But achieving eradication requires continued work in the health systems of countries that remain at risk. WHO has a strategic plan in place to maintain a polio-free world after eradication; strengthen immunization systems, including surveillance for vaccine-preventable diseases; and improve emergency preparedness and detection capacity.
“Current efforts to implement the TB elimination strategy approved by the World Health Assembly are not sufficient,” according to delegates. The disease claimed 1.7 million lives in 2016. It remains the most deadly infection on the planet and is one of the top ten global causes of death. A summit next September is expected to spur a renewal of high-level political commitment to accelerate action to end the disease. Delegates agreed on a resolution committing member states to accelerate their actions to eradicate it.
Cholera kills about 95,000 people and affects 2.9 million more each year. It ravages communities in conflict, with a lack of infrastructure, poor health systems, and malnutrition. More than 2 billion people still lack access to safe water and are potentially at risk of contracting the disease. Delegates supported a resolution urging cholera-affected countries to implement a roadmap aimed at reducing cholera deaths by 90 percent by 2030. The resolution also urges the WHO to increase its capacity to help them combat the disease.
Recognizing the potential of digital technologies to play an important role in improving public health, delegates agreed to urge member states to prioritize the development and increased use of these tools as a means to promote universal coverage and advance the Sustainable Development Goals. They called on WHO to develop a global strategy and support the scaling up of these technologies in countries by providing technical assistance and policy guidance, monitoring trends and promoting best practices to improve access.
Delegates agreed to a resolution aimed at reducing the number of people worldwide who die or are physically or mentally disabled from snakebite. It is estimated that between 1.8 and 2.7 million suffer from snakebites each year, of which between 81,000 and 138,000 dies. For everyone who dies, another four or five are left with disabilities such as blindness, restricted mobility or amputation, and post-traumatic stress disorder. It is a disease that overwhelmingly affects people in poor farming and livestock communities and last year WHO categorized it as a neglected tropical disease of high priority.
23% of adults and 81% of adolescents aged 11-17 years do not meet the overall recommendations for physical activity. Member States supported the WHO Global Action Plan on Physical Activity (Gappa), a new initiative aimed at increasing the participation of people of all ages in sport and the ability to promote health and combat non-communicable diseases, including heart disease, stroke, colon cancer, and helps to improve mental health and quality of life.
It is estimated that one billion people will benefit from assistive devices – such as wheelchairs, hearing aids, walking sticks, prosthetic limbs – a figure that will increase to more than two billion by 2050. However, 90% cannot afford them, due to high costs and lack of availability. Delegates adopted a resolution urging member states to develop, implement and strengthen policies and programs to improve access to assistive technology.
International Health Regulations
The International Health Regulations (IHR) are a binding legal instrument for 196 countries. It aims to help the international community prevent and respond to serious public health risks that have the potential to cross borders and threaten people around the world. The IHR, which came into force on 15 June 2007, requires countries to notify WHO of certain disease outbreaks and public health events. Delegates welcomed a proposed five-year global strategic plan to improve public health preparedness and response through the implementation of this regulation.
Delegates supported the Pandemic Influenza Framework, which has two objectives: to strengthen information sharing on the influenza virus with pandemic potential and to increase developing countries’ access to vaccines, antiviral drugs, and other essential response commodities.
Rheumatic fever and rheumatic heart disease
Rheumatic heart disease is a condition that arises from acute rheumatic fever; it occurs most commonly in childhood and disproportionately affects girls and women. Despite the availability of effective measures for its prevention and treatment, cases have not decreased significantly in recent years. Socio-economic and environmental factors, such as poor housing, malnutrition, overcrowding, and poverty, increase the likelihood and severity of the condition. Delegates agreed to a resolution calling on WHO to launch a coordinated global response to the disease, which affects about 30 million people each year. By 2015, it was estimated to have caused 350,000 deaths.
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